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28 Speak Out June 2016
“Speech
pathologists should
be an essential
member of the
care and support
team for older
Australians.”
federal government investigate the service delivery
model of speech pathology services in residential
aged care with a focus on contracting arrangements.
Importantly, you recommended that a cost benefit
analysis be completed that considered the current
funding of speech pathology services in the aged care
sector. Whilst it is unfortunate that we are still waiting
a government response to your final report, we want
to assure you that our Association has valued your
work and over the past year and a half, has invested
our member resources to address some of your
recommendations that were able to be advanced
without government support. Many of these are within
the aged care space. I would be happy to speak
with you about these however I will now hand over to
Dr Bennett to highlight some workforce challenges
identified in recent research into the speech pathology
aged care workforce that we have co-led.
Although, we are still awaiting publication in peer
reviewed journals, preliminary results indicate that
speech pathologists working in the aged care sector
have identified a number of challenges to ensuring
older people have access to our expertise. Critical
barriers to services include current funding and
service delivery models that emphasise swallowing
assessment and do not fund communication
intervention. Staffing ratios are so low and case load
pressures so high that care can be compromised.
These pressures often lead to ineffective adherence
to our clinical recommendations for aged care clients.
This is made worse by the prevalent sub-contracting
arrangements where speech pathologists are largely
unable to influence policy and procedures within a
facility and have restricted opportunity to engage in
interdisciplinary care.
As the roll out of the aged care reforms progresses,
we are growing increasingly concerned about
arrangements that appear to further restrict
rather than enhance access to speech pathology
services for older people—particularly those
with communication problems and those within
community and home based settings. This has
repercussions on our workforce planning within our
profession—we know there is significant demand
for our services but there are persistent barriers
to supply. We are still seeing a lack of awareness
of the need for communication interventions in
residential aged care and funding for these services.
We know the entry point to the aged care system
relies heavily on an understanding of communication
and swallowing problems and the need to refer to
speech pathologists by Regional Assessment Service
Assessors. Sub-contracting arrangements for private
providers are growing increasingly complex and
problematic for our private sector. Furthermore, we
are still experiencing significant difficulty getting all
speech pathologists listed as providers on the My
Aged Care website.
We believe that Australian Government leadership is
crucial to progressing aged care workforce planning
in the context of the aged care reforms. Whilst the
sector has an important role to play in identifying and
improving workforce planning for the aged care sector
broadly, in a competitive market place, it is unrealistic
to expect the “sector” to determine the solutions
in isolation from government. We are certainly a
profession that would welcome concrete support
from government to help our workforce planning and
design. Thank you.”
Policy & Advocacy